Organization
MELVIN CANELL ED D
Active
Other names
Affilliates in Psychology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIN M FIERRO (OFFICE MANAGER)
(308) 534-7170
Entity
Organization
Contact information
Practice address
1510 E 4TH ST, SUITE 1, NORTH PLATTE, NE 69101-4304
(308) 534-7170
(308) 534-2377
Mailing address
PO BOX 892, NORTH PLATTE, NE 69103-0892
(308) 534-7170
(308) 534-2377
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
212944723
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212944723
STATE OF NE ID
NE
01
—
259226000
MAGELLAN MIS
NE
01
—
A937805
VALUE OPTIONS
NE
Enumeration date
10/20/2006
Last updated
07/09/2008
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